Hysterectomy?
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Considering having a hysterectomy?  We'll try to  provide some information on this page that may be of help to you.  This page is in no way a complete document about hysterectomy.  Talk with your doctor at length about any concerns you may have. 
 
Make sure your doctor knows *everything* you are taking before your surgery is scheduled (cold pills, pain killers, vitamins, supplements, prescription medications - everything) so that (s)he can tell you which ones to discontinue prior to your surgery!

What IS a hysterectomy?  To put is very simply a hysterectomy is the removal of a woman's uterus. But having said that you need to be aware that there are now many and varied approaches to a hysterectomy.  Some of them are listed below with a very brief explanation of each.  Remember that only you (with a doctor that you trust) can make the decision as to what is best for you.
 
Before you have a hysterectomy chances are your doctor will perform these tests:
  • a complete pelvic exam that includes the ovaries and the uterus
  • a pap smear
  • a complete blood workup
  • a pelvic ultrasound
 
Now the types of surgeries:
  • TAH (total abdominal hysterectomy): This involves an abdominal incision through which the uterus (including the crevix) and the ovaries are removed. This allows the entire abdomen to be examined and may include the removal of the appendix as well.
  • TVH (total vaginal hysteretomy): This involves entrance through the vaginal canal and the removal of the uterus (including the crevix), ovaries and possibly the appendix as well.
  • LAVH (laproscopic assisted vaginal hysterectomy): This involves entrance through the vaginal canal with a laproscope inserted into the abdomen near the navel. The uterus is removed and the cervix, ovaries and appendix may or may not be removed depending on what the doctor sees while in there.
  • SH (Supracervical hysterctomy): This involves an abdominal incision and the removal of the uterus alone, leaving the cervix intact. It may or may not include removing the ovaries.
  • LSCH (Laparoscopic supra cervical hysterectomy): This is much like the SH but makes use of a laproscope inserted through the abdominal wall throught which the uterus is removed. It may or may not include the removal of the ovaries as well.
  • RA (Radical hysterectomy): This is much like the TAH but may include removal the upper vagina and other tissues surrounding the uterus.  (usually done only in the case of early cervical cancer)

Things to do, or buy, or consider before the going to the Hospital:

Consider buying a lightweight lycra panty girdle - to wear after surgery. It can provide light support to the incision site and protect you sensitive skin from the unpleasant sensation of clothing and bedding rubbing against it.

Consider buying a full body pillow (or have some ‘firm’ pillows) to curl up with for comfortable sleeping after surgery. Have some small pillows (airline or baby) to use to cushion your tummy. This is especially helpful for the ride home from the hospital to cushion the abdomen from the seat belt.

Purchase panty liners for post-op vaginal drainage (no tampons are allowed). Or ask the hospital to provide some for you to bring home. If you can find them, get the ‘long’ kind. If you cannot find longer ones consider purchasing some of those designed for bladder problems...often those can be found in longer sizes.

Buy or find loose fitting clothes - to take with you to the hospital for your ride home and then at home later. Clothes with either elastic waistbands or no waistband at all (dresses, jumpers, housecoats).

Go grocery shopping prior to surgery and stock up on food that can be easily prepared or cooked and frozen ahead of time, for post-operative meals.  If you have no one you can rely on to do any of your other shopping until you can go again, be sure to stock up on any non-perishables you might need as well while you are unable to shop (such as pet foods, kitty litter, toilet paper, etc.!).

Purchase cranberry juice (good home remedy for urinary tract discomfort), yogurt (good remedy to help avoid yeast infections after antibiotic medication and to soothe upset bowels) and salad fixings (good for roughage and easier bowel movements).

You might want to buy (if you do not already have one) a hand-held spray attachment for the showerhead. This will be especially helpful if you should become dizzy when trying to take a shower while standing up.  You can sit on the side of the tub or on a low stool in the tub to bathe this way.

Bring an over the counter drug called "Phazyme" (generic name: symethicone) with you in your overnight bag for gas pains. You might have horrible gas pains afterwards and they don't always have this "miracle" pill at the hospital. They can rid you of gas super quick!

Buy thank you notes and stamps to use when you feel up to writing.

If you feel that you'd rather not have lots of visitors while you are in the hospital you might consider telling your friends that before your surgery - to avoid any possible hurt feelings later.  Also, if you have friends (on-line or personal!) who will want an update on your progress be sure to leave a list of those people with someone you can rely on to make that contact....include email addresses or phone numbers on that list.

Make arrangements to have at home assistance available for after surgery. A spouse can be a helper, but only you will know whether additional assistance is needed for younger children or carpooling, grocery shopping. Better to have them lined up and not need the help than to need it and not have it available. If possible, hire a maid for a few weeks.

Arrange for your softest linens to be on the bed when you get home from the hospital. Have the telephone, reading materials, and anything else you may need, within easy reach of your bed.

Schedule an appointment with your hairdresser prior to surgery.

If possible, have your prescriptions filled before you leave the hospital.

Talk with your doctor, at length, about any concerns or questions you may have. If you have a history of cystitis discuss this thoroughly with your surgeon. Sometimes they will avoid using a catheter, if possible, but you need to ask.

Understand that some or all of your pubic hair may be shaved for the surgery. An abdominal incision may only require the shaving of the mons. A vaginal hysterectomy may be only the labia or could be the entire area. Some doctors will allow you to do this at home, but most will NOT! They do not want to have a nick or cut to deal with and prevent infection in.

Suggested ‘take along’ items for your hospital stay:

  • Comfortable nightgown and robe. Keep in mind that you will be walking the hallway with an IV so take button down instead of over-the-head nightwear. A wrap-around robe may be all that you use over the hospital gown.
  • Bedroom slippers. The easier they are to slip your feet into the better.
  • Pillows - if you like more than the one that is standard hospital issue!
  • Lightweight socks (toes get mighty cold in hospital rooms)
  • Chap stick
  • Toothpaste/toothbrush/mouthwash
  • Hair brush/comb
  • Breath mints, hard candies, and gum
  • Reading materials, cards, crossword puzzle books, etc., to occupy your awake time!
  • If you are a smoker ask your doctor for nicotine patches and/or nicotine gum to get you through the hospitalization.
  • Air-line pillow/baby pillow as discussed above
  • Underwear - larger in size than normal for when catheter is removed so that you can secure sanitary napkins to them.
  • Loose fitting pants and top for the trip home.

Suggestions for After Surgery Care

As soon as you can, ask the nurses if it is safe for them to remove your urinary catheter. Sometimes they want to leave it in overnight. In which case, have them remove it the first thing in the morning as it can cause horrible bladder infections and a lot of discomfort.

Your surgeon and the hospital staff will send you home with post-operative instructions. Follow them!!

Here are some of our suggestions:

For your ride home: Keep that little pillow we mentioned handy to tuck between the seat belt and your tummy.  Ask whoever is driving you home if they would mind letting a wee bit of air (a pound or so!) out of their tires for the ride.  It won't damage the tires at all and it will most definitely make the cushioning of your ride much softer! Even the vehicle with the best (softest) suspension in the world will jar your insides something fierce on that first ride - every tiny ripple in the road feels like driving over a log. So any extra softness provided for that ride is to be much appreciated!!

Take it easy. Your body has just been through a major trauma and will need rest and pampering. Your incision may look as though it is healing well on the outside - however - inside there are layers and layers of tissue that will take longer to heal. Things like making the bed, doing laundry, or even sitting at the computer may be too much. The more rest and good nutrition you get the easier your recuperation will be. Several naps a day are suggested.

Do not push, pull, reach or lift for two weeks to allow internal sutures to heal.

Drink plenty of water. This is necessary for your body to return to normal bladder and bowel function. If you begin to develop changes in urination, pain, burning or frequency, report this to your doctor immediately.

Do not strain to have a bowel movement. Gas is normal. Using Gas-Ex, Phazyme (generic name: symethicone) or similar over-the-counter therapies will help. If constipation becomes a problem consider adding more fiber to your diet, using Citrucel, or using a MILD stool softener. Pain medications tend to slow down intestinal mobility and can cause constipation. To help with this problem, walk. Walk slowly, as normally as possible, and as much as you comfortably can. And drink lots of water. If you should you find yourself constipated, and if you're a regular coffee drinker, have a cup of coffee!

Attempt to stand up as straight as possible. With any abdominal incision there is the tendency to slouch over because it hurts. But if you continue to do so the muscles will contract and erect posture will be difficult later.

Get out of the hospital as quickly as you can. It is the worst place to be to heal. Try to stay no more than two days. Your real recovery will begin when you get home and can be comfortable. Begin to take walks as soon as you're able and gradually increase your time up and on your feet. Make sure you have someone with you at home. You need your rest!

About your sleeping arrangements. Your most comfortable pre-op position in bed may not be comfortable post-operatively, at first. Experiment with recreating the positions that were comfortable in a hospital bed with pillows under your knees and supporting your back. If you find that your bed partner’s night time movements are causing you discomfort boot him out of the bed for a while! Or move yourself to a different bed for a bit!!

Do not bathe or shower until your doctor gives permission to do so. When it is allowed, make sure someone is nearby in case you need them - at least the first few times you bathe.  You may have been offered the opportunity to shower before you even leave the hospital!

Do not drive a car until the doctor allows it. The need to brake suddenly may be painful early on and that is a dangerous position to be in.

Keep stress levels down. Let others help you when and where needed. This is not the time to be superwoman.

No lifting. This means children, pets, and anything over the weight limit your doctor has given you. Although you may not feel it, abdominal muscles are used in these activities and these muscles need time to heal after being cut. This means too that the kids and pets cannot climb all over you!

Home alone during the day? If you will be home alone during the day have an ice chest next to your bed or chair for fruits, drinks, and sandwiches; and a table for your phone, books, etc.!

Try to wean your usage of narcotic pain medication opting for analgesics as soon as possible. But - it is important that you be pro-active in the use of pain meds, especially at first. If you know you're going to be up for a while, or doing something more active, taking some pain meds may help prevent the "backlash" that we sometimes get. There is no need to suffer through the pain just because someone else thinks you shouldn’t be taking pain meds!! Taper down as soon as you can, by all means, but don't push it.

You may want to update your telephone answering machine daily to avoid having to answer the phone every time it rings and give individual status reports to well-wishers checking in on you.

If you feel that you would like to try massaging the incision area to speed up the healing - discuss this with your doctor before you do! If your doctor says it is okay to try it do not use any creams, lotions, or Vitamin E oil until the incision is completely closed. You could potentially cause an infection should you try this before the incision is completely healed.

Somewhere else to find great answers:
 
As much as I dislike sending you elsewhere in your search for answers, I must acknowledge that I cannot give you everything you may need here at our site.  So, with that in mind and keeping an invitation to our site and our board totally open to you, I am going to suggest that you visit the HysterSisters Web site too.  They have a much broader forum for answering your questions and also provide a platform open to discussion with other women who are where you are right now.